
			<div id="header_text">
				
			</div>

			<div id="body_text">
			<fieldset>
				<legend>Please provide the information requested below.</legend>
					<form name="signup" id="signup" action="/scripts/submit.php" method="post"  enctype="multipart/form-data">
						<ul>
							<li> <label for="title">Title of your Story</label>
								<input type="text" name="title" id="title" size="30" />
							</li>
							<li> <label for="destination">Destination</label>
								<input type="text" name="destination" id="destination" size="30" />
							</li>

							<li> <label for="photo">Upload your Photo</label>
								<input type="file" name="filename" id="filename" size="30" />
							</li>
							
							<li> <label for="story">My Story</label>
							<p class="story_help">(Please tell us in 1000 words or less about a travel or other experience you feel was especially exciting or meaningful.)</p>
								<textarea name="story" id="story"></textarea>
							</li>
								
							<input type="hidden" id="email" name="email" value="<? echo $emaila  ?>" />
							
							<li id="actions">
							<label for="reset"></label>
								<input type="reset" id="reset" value="" />
							
							<label for="submit"></label>
								<input type="submit" id="submit" value="submit" />
							</li>
							
							
						</ul>

						
					</form>
			</fieldset>

				
			</div><!-- end body text -->